Five Things Not to Do to Increase Physical Activity Mark Fenton - - PowerPoint PPT Presentation

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Five Things Not to Do to Increase Physical Activity

Mark Fenton Tufts University

• Jan. 2016

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Five things . . .

• Don’t tell people to

exercise.

• Stop doing health fairs.
• Never beg for physical

activity infrastructure.

• Do not be happy unless you’ve put stuff
• n the ground and changed the rules.
• Don’t create a big coalition

w/ monthly meetings.

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#1 Don’t just promote exercise.

Kingsport TN Anchorage AK

How we often depict PA . . .

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National Physical Activity Plan humankinetics.com

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The Stickiness Problem

Effect of Short Bouts, Home Treadmills (Jakicic et.al., J. Amer. Med. Assoc., 282, 16)

60 120 180 240 6 12 18 months

Exercise (min/week)

LB SB SBT

?

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60 120 180 240 6 12 18 months Exercise (min/week LB SB SBT

The Stickiness Problem

Effect of Short Bouts, Home Treadmills (Jakicic et.al., J. Amer. Med. Assoc., 282, 16)

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Energy Expenditure

Structured vs. Lifestyle Activity

(Dunn et.al., JAMA 281, 4)

32 33 34 35 6 12 18 24 months Energy Expenditure (kcal/kg/day)

Lifestyle Structured

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Self-help vs. Commercial Weight Loss Programs

(Heshka et.al., JAMA 289, 14; April 9, 2003)

• 7
• 7
• 6
• 6
• 5
• 5
• 4
• 4
• 3
• 3
• 2
• 2
• 1
• 1

6 12 12 18 18 24 24

months

Weight Change, kg

Se Self-h

• help

Comme mmercial

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The point: Simply teaching, promoting, cajoling, urging, & bribing people to “exercise” is not

• enough. The focus must be
• n increases in routine, daily

physical activity for everyone.

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The story in just three numbers:

30 minutes of daily physical activity recommended (60 min. for youth).

(www.health.gov/paguidelines)

% of Americans actually meet these recommendations (thru LTPA).

(Troiano et.al., Med Sci Sports & Ex., 40(1), 181-188, 2008)

,000 estimated annual deaths in America due to physical inactivity & poor nutrition. (2nd only to tobacco.)

(Mokdad et.al., JAMA. 2005 Jan 19;293(3):298)

20 365

<

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Pre-1973 Post-1973

Berrigan D, Troiano R. The association between urban form & physical activity in U.S. Adults., Am J Prev Med. 2002 Aug;23(2 Suppl):74-9.

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Public Policy - laws, ordinances, permitting practices & procedures

Community - networks, facilities

Institutional - school, work, health care & service providers

Interpersonal - family, friends, colleagues

Individual motivation, skills

Social Ecology Model

Sallis & Owen, Physical Activity & Behavioral Medicine.

Determinants

• f behavior

change

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• Only reaches

those who choose to show up!

• Doesn’t

necessarily change behavior.

• Doesn’t change

the context.

#2 No more health fairs.

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• 1. Varied destinations within

walk, bike, & transit distance.

• 2. Network of sidewalks, trails,

bike lanes, transit.

• 3. Functional inviting designs

for pedestrians, bicyclists, & transit users.

• 4. Safe & accessible for all

ages, incomes, abilities

Denton TX

www.activelivingresearch.org

Can our day-to-day environment be made sticky?

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Four Elements of Healthy Design: www.activelivingresearch.org

Functional site design Safety & access for all Ped, bike, & transit network Mix of destinations

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The US Surgeon General concurs:

• 1. Promote more walking.
• 2. Build a more walkable world.

www.surgeongeneral.gov/StepItUp

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• St. Louis

Billings Queens NY

Low cost options & demonstration projects.

E.g. Inexpensive, reversible curb extensions.

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Street furnishings, wayfinding, parklets.

Montpelier Walkyourcity.org

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Anaconda, MT “pop-up” curb extension.

But can the biggest truck make the turn? Try it!!

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Better Block demonstration Youngstown OH betterblock.org

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Diagonal parking increases

• n-street

capacity, but . . .

Reverse angle:

• Less severe &

costly collisions.

• Safer for bikes.
• Pedestrians out
• f the road.

Akron OH

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Hutchinson, KS reverse angle parking “tryout”

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Trial - Villa Rica, GA

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#3 No begging for infrastructure.

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Bicycle network elements:

Protected bike lane Sharrow Bike lane American River Trail Sacramento

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*www.ceosforcities.org/work/walkingthewalk www.walkscore.com

Selling it: Make the economic case.

Walking the Walk: How Walkability Raises Housing Values in U.S. Cities (CEOs for Cities)*

Higher score = $4,000-$34,000 home value

walkscore = 12 walkscore = 67

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On Common Ground

Nat’l Assoc. of Realtors Summer 2010; www.realtor.org

The Next Generation of Home Buyers:

• Taste for in-town living.
• Appetite for public

transportation.

• Strong green streak.
• Plus, Americans are

driving less overall!

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Walkability.

Why we care & why you should too!

National Association of Home Builders, Mar. 2014

• Consumer desire
• Flexibility in design
• Lower development

costs . . .

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Homes abutting trails sell in 1/3 to 1/2 the time, and at a larger % of asking price, than non-abutters.

Counter the NIMBYs & CAVEs.

Trails & Greenways: Advancing the Smart Growth Agenda Rails-to-Trails Conservancy Bedford MA

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Smart Growth & Economic Success

www.epa.gov/smartgrowth/economic_success.htm

• Dec. 2012, Nov 2013

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Environmental & economic sustainability

www.epa.gov/smartgrowth

• Support, protect the rural

landscape – Economic development – Protecting agriculture

• Help existing places,

downtowns thrive.

• Create great new places

– Designate growth areas – Constrain road costs

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Benefits of protected bike facilities

BikeWalkAlliance.org GreenLaneProject.org

• Healthier, more

productive workers.

• Support real estate

values.

• Increased retail revenue.
• Recruiting & retaining

skilled employees.

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#4 Don’t just create a giant coalition w/ monthly meetings.

• Schools & education
• Planning & Zoning
• Engineering, DPW
• Parks & recreation
• Historical Society
• Public Health & Safety
• Chamber of Commerce
• Economic Development, employers
• Neighborhood Assoc., church & service groups
• Environment, Conservation . . .

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Not so organized chart:

Health Transport Planning AHA ADA ACS DPW Rec. Parks Trails Electeds Schools Neighbor- hoods PTOs Hospital Insurer Bike/Ped Advocates Employers Developers YMCA

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Build a “stealth” team:

Health DPW

Planning

AHA ADA ACS

Transport

Rec. Trails Elected

Neighbor- hoods

PTOs Hospital Insurer

Bike/Ped Advocate Banks

NAHB

Churches

Employers

Developer

NAR

Vision Jobs Reach

Service Orgs.

Agriculture

Enviro.

Econ. Devlpmt Schools Parks Found. YMCA

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Focused action teams:

SRTS

Complete Streets

‘Stealth’ Leadership Team

Open space protection

Ped/Bike Plan Transport trails Zoning updates

• Small, strong,

well-connected leadership team.

• Tight, focused

action teams on specific topics.

• No monthly

meetings, just functionally targeted work.

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#5 Don’t bother unless you’re working to change infrastructure & policies!

• 1. Healthy planning & zoning.
• 2. Complete Streets.
• 3. Transportation trail networks.
• 4. Transit- & bicycle-friendly policies.
• 5. Comprehensive Safe Routes to School.

(Fenton, Community Design & Policies for Free Range Children, Childhood Obesity 8(1), Feb 2012)

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5a Best practices in zoning.

• Narrow streets, sidewalks both sides, required

links to trail system (existing & planned).

• Compact design, shared open space.
• Mix housing types, sizes (& incomes).

Less of this . . . More like this?

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Steer residential & retail development back into cities and towns.

E.g. Naperville, IL Greenfield IN

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Policy – Multi-modal Transportation Analysis

• vs. Traffic Impact Analysis (MMTA vs TIA)
• Typical: Turn lanes, signal . . .
• Sidewalk link? Benches? Bike lane, sharrows?
• Transit shelter, pathway?

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5b Policy: Complete Streets

• 1. Pedestrians, cyclists, transit

riders, & drivers of all ages & abilities considered whenever we touch a corridor.

• 2. Limited, specific exemptions.
• 3. Update design guidelines

www.completestreets.org

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Update guidelines, design requirements.

• Don’t reinvent the wheel! Nat’l Association of

City Transportation Officials have compiled the evidence base and best practices.

Urban Street Design Guide

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Complete Streets for a complete network

• 5 or 4 lanes reduced to 3,

“road diets.”

• Reduces collisions &

severity.

• Improves performance

for pedestrians, bikes.

Urbana, IL; before & after.

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• E. Avenue A;
• ther four-

lane roads.

Hutchinson, KS.

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• E. Avenue A, Hutchinson, KS – they did it!

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5c A comprehensive network of transportation trails.

• Connect to other parts
• f network (sidewalks,

bike lanes, transit).

• Focus on destinations

(schools, shopping, parks, senior housing)

• Plan for & fund

maintenance!

Cornell Elem.

Rapid Creek Tr., Boone NC

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Eisenbahn State Trail, West Bend, WI

Decorah Elem.

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E.g. Nashville, TN Metropolitan Planning Organization (MPO)

• Scoring for Transportation Improvement Plan

(TIP) includes impacts to pedestrian, bicycle, & transit travel, not just motor vehicle Level of Service (LOS).

• 60% depends on

active modes!

• Result: auto-only

projects don’t get funded.

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Go do tomorrow . . .

• Form a truly mixed stealth team.
• Organize some pop-up,

demonstration, & pilot projects. Big goals:

• Adopt routine MMTA (instead of TIA)
• Adopt Complete Streets & NACTO.
• Change your MPO’s project scoring.
• Update zoning for compact, healthy

growth.

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Resources for demonstration, pilot projects

• americawalks.org

Effective, . . . but generally inexpensive, simple, & reversible.

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• Policy change, routine

accommodation, paying for the infrastructure. Walk audits, inventory, events & short-term trials, Complete Streets resolution.

Companion pieces . . .

• Institutional

shift.

• Getting the

community

• n board.
• Resources.

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Summary:

• Sell leaders on the environmental,

economic, & public health benefits.

• Start w/ demonstrations & pilots.
• Operate on 3 levels: land use, active

network, site design/place making.

• Change the rules: policies,

procedures, & market incentives.

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Olshansky et.al., “A Potential Decline in Life Expectancy . . .” New Eng. J. of Med., March 17, 2005 www.markfenton.com

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Go do tomorrow . . .

• Form a truly mixed stealth team.
• Organize some pop-up,

demonstration, & pilot projects. Big goals:

• Adopt routine MMTA (instead of TIA)
• Adopt Complete Streets & NACTO.
• Change your MPO’s project scoring.
• Update zoning for compact, healthy

growth.